Rehabilitation strategies for wrist sensorimotor control impairment: From theory to practice

Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists
Christos Karagiannopoulos, Susan Michlovitz

Abstract

This clinical review discusses the organization, neuroanatomy, assessment, clinical relevance, and rehabilitation of sensorimotor (SM) control impairment after wrist trauma. The wrist SM control system encompasses complex SM pathways that control normal wrist active range of motion and mediate wrist joint neuromuscular stability for maintaining joint function. Among various known assessment methods of wrist SM control impairment, the active wrist joint position sense test is determined to be a clinically meaningful and responsive measure for wrist SM control impairment after wrist fracture. Wrist trauma may involve significant soft tissue injury (ie, skin, ligament, muscle), which could disrupt the generation and transmission of adequate proprioceptive input from wrist mechanoreceptors, thus leading to significant joint SM impairment. Various clinical examples of wrist trauma (eg, distal radius fracture, scapholunate joint injury) along with known prognostic factors (eg, pain) that may influence wrist SM control impairment recovery are discussed to illustrate this point. This article proposes promising rehabilitation strategies toward restoring wrist joint conscious and unconscious SM control impairments, integrating current re...Continue Reading

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Citations

Feb 7, 2019·JBJS Reviews·Robin N KamalSanjeev Kakar
May 17, 2018·Journal of Physical Therapy Science·Abdalghani YahyaMarcio Dos Santos
Oct 6, 2019·Experimental Brain Research·Abdalghani YahyaMarcio Dos Santos
Jan 14, 2020·The Journal of Hand Surgery, European Volume·Susanne ReinNane Euchner
Feb 13, 2021·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Zoe MilnerHayley O'Sullivan
Dec 5, 2017·Journal of Electromyography and Kinesiology : Official Journal of the International Society of Electrophysiological Kinesiology·Yasuhide YoshitakeMinoru Shinohara
Sep 8, 2020·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Marijn MuurlingWinfred Mugge

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